Insurance Update

SB 137 - Provider Directories

SB 137 established comprehensive requirements to ensure that health plans publish and maintain accurate, complete and up-to-date provider directories. Portions of the bill took effect on July 1, 2016, including the requirement that online and printed directories be made available to all consumers without restrictions or limitations. The Department of Managed Health Care (DMHC) is monitoring health plans’ implementation of the law. Health plans are required to establish policies and procedures that demonstrate compliance, including making all necessary revisions to existing contracts with providers, provider groups, and specialized health plans. 

The Department is meeting with stakeholders to develop the uniform provider directory standards and will hold at least one public meeting on the uniform provider directory standards that must be developed on or before December 31, 2016. Once these standards have been developed and adopted, plans will have 12 months to ensure their provider directories are compliant with those standards.

As the Department’s implementation of SB 137 progresses, the Department will publicize information regarding the public meetings and comment periods. For more information about opportunities for stakeholder participation please contact stakeholder@dmhc.ca.gov